Contents

Introduction

Cavernous sinus thrombosis is a rare and life-threatening condition in which a blood clot develops in the cavernous sinuses.

The cavernous sinuses are a series of hollow spaces located under the bottom of the brain, behind each eye socket. A major blood vessel called the jugular vein carries blood through the cavernous sinuses away from the brain.

When to see your doctor

You should always contact your doctor if you are experiencing a persistent and severe headache you have not had before, or if you develop swelling of the eyes or severe eye pain.

While it is highly unlikely to be the result of a cavernous sinus thrombosis, a persistent headache is a symptom that usually requires further investigation.

After an examination of your symptoms, you may be referred for several tests, including a computerised tomography (CT) scan](/condition/ct-scan), a magnetic resonance imaging (MRI) scan and [blood tests.

Why does cavernous sinus thrombosis happen?

Most cases of cavernous sinus thrombosis occur when a bacterial infection in another part of the skull or face spreads into the cavernous sinuses.

How is cavernous sinus thrombosis treated?

The main treatment for the condition is antibiotics, which are normally given through a drip into a vein in the arm. This treatment usually lasts at least three to four weeks.

Despite some uncertainty about their use, you may also be given additional treatment with anticoagulant medication](/condition/anticoagulant-medicines) (to dissolve and prevent blood clots) or [steroid medication (to reduce any swelling).

Most people will need to stay in hospital for several weeks or even months before they are well enough to go home.

some types of medication, such as the contraceptive pill, although this is very rare

Treatment

Cavernous sinus thrombosis is a serious condition that needs to be treated in hospital.

In most cases, you will be treated in an intensive care unit so your condition can be closely monitored.

Antibiotics

The main treatment for cavernous sinus thrombosis is antibiotic medication. This is started as soon as possible, even before tests have confirmed if a bacterial infection is responsible for the condition.

If tests later show that a bacterial infection did not cause the condition, antibiotic treatment may stop.

Most people will require at least a three- to four-week course of antibiotics to ensure the infection has been fully cleared from their body. These are given through an intravenous drip directly connected to one of your veins.

Around 1 in 10 people will experience side effects when taking antibiotics. These are generally mild and can include diarrhoea, nausea and a skin rash.

Anticoagulants

In some cases, you may also be given a medication called heparin to help dissolve the clot and prevent further clots. Heparin is an anticoagulant, which means it makes the blood less sticky.

However, there are some doubts about the use of anticoagulant treatment for cavernous sinus thrombosis, such as when it should be used and how long treatment should last. There is also a risk of serious problems such as excessive bleeding (haemorrhaging).

There is a lack of evidence concerning the use of anticoagulants for the condition because it is so rare that it is difficult to study. Nevertheless, the little research that does exist seems to suggest that anticoagulants can be an effective treatment for some people, and most doctors agree it should be used where appropriate.

Corticosteroids

You may also be given steroid medication (corticosteroids) in addition to antibiotics. Corticosteroids can help reduce the level of inflammation and swelling in your body.

However, as with anticoagulant therapy, there is little evidence concerning the effectiveness of corticosteroids in treating cavernous sinus thrombosis. Nonetheless, corticosteroids are thought to be beneficial for some people.

Surgical drainage

If the symptoms of cavernous sinus thrombosis were caused by an infection spreading from a boil or sinusitis, it may be necessary to drain away pus from that site. This can be done either using a needle or during surgery.